MDS 3.0 Item D0500J1: PHQ Staff Assessment - Presence of Short-Tempered Behavior

MDS 3.0 Item D0500J1: PHQ Staff Assessment - Presence of Short-Tempered Behavior

Introduction

Purpose: Short-tempered or irritable behavior in long-term care residents may be a sign of underlying mental or emotional distress, including depression, anxiety, or cognitive decline. MDS Item D0500J1 focuses on whether staff have observed that the resident has been short-tempered or easily irritated over the past two weeks. Accurate coding of this item helps identify potential mood disturbances and supports the development of appropriate care plans.

What is MDS Item D0500J1?

Explanation: MDS Item D0500J1 is part of the staff assessment for mood under Section D: Mood. This item asks whether staff have observed the resident displaying short-tempered or irritable behavior during the past two weeks. It is used when the resident cannot or does not complete the mood interview (PHQ-9), and staff observations are recorded instead. Identifying the presence of irritability is crucial for assessing the resident’s emotional state and ensuring that interventions are in place to manage potential mood issues.

Guidelines for Coding MDS Item D0500J1

Coding Instructions: To code MDS Item D0500J1, staff members assess whether they have observed that the resident has been short-tempered or easily irritated over the past two weeks. The coding is binary:

• 0 - No: The resident has not shown signs of short-tempered or irritable behavior.
• 1 - Yes: The resident has shown signs of short-tempered or irritable behavior.

Example Scenario: If a staff member notices that a resident has been easily frustrated or has snapped at others more frequently over the past two weeks, you would code D0500J1 as 1 - Yes. If there have been no signs of such behavior, the code would be 0 - No.

Best Practices for Accurate Coding

Observation: Staff should carefully observe the resident’s behavior and emotional responses during interactions with others over the two-week period. Note any incidents of irritability, frustration, or snapping at others.

Documentation: Thorough documentation is essential. Record specific examples of irritable or short-tempered behavior, noting the context in which it occurred. This documentation helps support the coding decision and informs the care plan.

Communication: Share observations of short-tempered behavior with the interdisciplinary care team. This information may prompt further assessments to explore underlying causes such as pain, discomfort, or mood disturbances, leading to appropriate interventions.

Training: Regular training for staff on recognizing and documenting signs of irritability and short-tempered behavior is important. Training should also include strategies for managing and de-escalating tense situations with residents.

Conclusion

Summary: MDS Item D0500J1 is essential for identifying residents who may be experiencing irritability or short-tempered behavior, which can indicate underlying mental health or emotional distress. Accurate coding of this item ensures that potential mood disturbances are recognized early, allowing for timely interventions that can improve the resident’s overall well-being.

Click here to see a detailed Step-by-Step on how to complete this item set.

Reference

This guide is based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, Page D-23.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item D0500J1: "PHQ Staff Assessment - Presence of Short-Tempered Behavior" was originally based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. Every effort will be made to update it to the most current version. The MDS 3.0 Manual is typically updated every October. If there are no changes to the Item Set, there will be no changes to this guide.

This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, in understanding and applying the correct coding procedures for this item within MDS 3.0. The guide is not a substitute for professional judgment or the facility’s policies. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice.